| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $906.96 | $906.96 | $906.96 | |
Aetna
| Professional | $872.08 | $906.96 | $915.68 | |
Cigna
| Facility | $872.08 | $872.08 | $872.08 | |
Cigna
| Professional | $872.08 | $872.08 | $872.08 | |
United
| Professional | $872.08 | $872.08 | $872.08 |